The American journal of the medical sciences
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Review Case Reports
Immune Thrombocytopenia in a Kidney Transplant Recipient Treated with Romiplostim.
We present a case of immune thrombocytopenia following a living donor kidney transplant. Thrombocytopenia started two days after transplant and continued up to seven weeks after transplant, despite an extensive workup, treatment with steroids, intravenous immune globulin, and alterations in immunosuppression and other medications. ⋯ The patient's graft function has also been stable. This experience suggests romiplostim is safe and effective for persistent immune thrombocytopenia in kidney transplant recipients.
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Human pulmonary dirofilariasis (HPD) is a rare zoonotic disease caused by Dirofilaria immitis, the nematode responsible for canine cardiopulmonary dirofilariasis (dog heartworm). The incidence of HPD is on the rise throughout the world due to increased awareness and factors affecting the vector (mosquito). Humans are accidental hosts for D. immitis. ⋯ There are no specific clinical, laboratory, or radiologic findings that differentiate HPD from other causes of a pulmonary nodule. Although serologic tests exist, they are usually not commercially available. The majority of patients are diagnosed by histopathologic identification of the decomposing worm following surgical resection of the lesion.
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Following the high morbidity and mortality due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infections in New Orleans, Louisiana, we sought to assess progress toward herd immunity. ⋯ SARS-COV-2 IgG antibodies were prevalent only in 8% of the participants. IgG prevalence was highest among non-Hispanic Blacks and participants with higher BMI but was lower among older participants.
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Polycythemia vera (PV) is a common type of Philadelphia chromosome-negative chronic myeloproliferative disorder. PV-associated kidney disease is rarely reported and remains poorly understood. It has been observed that chronic kidney disease could be a risk factor for poor prognosis in PV. ⋯ Patients with untreated or uncontrolled PV could have massive proteinuria and advanced CKD, pathologically showing ischemic, sclerosing glomerular lesions with hypercellurity, glomerular crescents and endocapillary proliferation. IgA nephropathy was most commonly diagnosed. These findings deserve attention because early screening and effective control of PV may benefit the long-term kidney prognosis.
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Observational Study
Hip Fracture Risk in Elderly with Non-End-Stage Chronic Kidney Disease: A Fall Related Analysis.
The aim of this study was to evaluate the risk of fracture as a consequence of trauma and its association with kidney function status in a cohort of elderly patients. ⋯ Our study confirms that patients with non-end stage CKD have an increased risk of femur fracture after a fall. Our data supports the hypothesis that this risk could be associated with increased bone fragility in CKD patients. Active osteoporosis therapy was found to be an effective preventive factor in our cohort.